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THE MANAGEMENT OF 

CAMP ALGER AND 

CAMP MEADE. 



KEPKIHTBD FROM THB 

Neto ITovfe ^elifcal 3Jout;nal 
for September ^4, 1898. 



V „ H')^' 



1898. . 



-iiifWASH 



> Reprinted from the Ne^c York Medical Journal 
S" for September 2J^, 1898. 

ro 

cD 



THE MANAGEMENT OF CAMP ALGER 
AND CAMP MEADE. 

Headquarters Second Army Corps, 
Camp Meade, Pennsylvania, 
Chief Surgeon's Office, September 15, 1898. 

To the Editor of the New York Medical Journal: 

Sir : In reply to your letter of September 6tli request- 
ing a statement of the facts relating to certain news- 
paper reports with regard to the condition of Camp 
Meade and to the health of the men in that camp, etc., I 
have to thank you for the opportunity given me. 

While this may not benefit me with the general pub- 
lic, who are so ready to accept the attacks and criticisms 
of newspapers and personal letters which might, and no 
doubt were intended to, injure my professional and 
official standing, yet I have the satisfaction of hoping 
it will benefit the medical corps of the army in the esti- 
mation of the medical profession, who alone are quali- 
fied to judge. 

I will preface my statement with a general history 
of Camps Alger and Meade, of which I was and am 
chief surgeon, and then take up under the several head- 
ings the main points of interest to enable the profes- 
sion to judge of the management of affairs by the medi- 
cal department. 

I was for the greater part of the time the only 
regular surgeon in control of my department. One 
other surgeon reported to me after some time, and 
after doing duty in my office for a short time, I had to 



2 CAMP ALGER AXD CAMP MEADE. 

send him with two raw brigades to Cuba. Another 
regular surgeon arrived about this time and assisted me 
in my office, and when I learned of confusion in the 
medical dapartment in Thoroughfare Gap, and of the 
breaking out of typhoid fever at Manassas, I had to 
send him there to bring order out of chaos; finally, 
when the affairs of the large division hospital at Dunn 
Loring had to be wound up after departure of most of 
the troops from Camp Alger, he had to step into the 
breach there. 

The result was that I was practically the only sur- 
geon with military training to look after the physical 
welfare of thirty thousand men. 

The division surgeons were volunteers with no 
knowledge of army organization, and had to be taught 
by me pari passu with their subordinates. 

Any one who knows what it means to teach raw 
troops how to procure food, water, fuel, clothing; to 
carry out ordinary principles of hygiene; in addition 
to this, to organize two large division hospitals, equip 
the hospital department of several large commands for 
active campaigns; to transfer, organize, clothe and 
equip a hospital corps of about seven hundred men, 
and to put them through some instruction — can guess, 
not realize, the Herculean task I had to perform. Add 
to this the introduction of a complete system of sani- 
tation and medical organization embodied in circulars 
and sanitary recoiiniiendations, and he will ask himself 
if it is possible for one man to perform all this work. 
If we consider in addition to all this the discomforts 
of cam]) life, the heat of the southern summer, and the 
great extent of the camp, covering as it does a surface of 
a number of miles, it would be a matter of surprise to 
any disinterested observer if no mistakes were com- 
mitted; and still 1 believe I am able to prove by docu- 
ments that everything that could be done by me to pre- 
serve the healtli of the camp was recommended, and 
in all cases ordered by the commaTiding general. 

But issuing orders and iuiving them carried out are 



CAMP ALGER AND CAMP MEADE. 3 

two different things, and that" is where the cause of sick- 
ness in Camp Alger lay. An aggregation of thirty thou- 
sand men under the drawbacks of a camp, the fatigue of 
the necessary military exercises and manual labor, the 
men barely controlled by their officers (chums and towns- 
men of the enlisted men), an absence of officers trained 
in the knowledge of and recognizing the necessity for the 
strictest sanitary measures, the men eating and drink- 
ing inordinately, the food poorly cooked, no one to 
teach the cooks or understanding the proper manage- 
ment of the ration, so that the men were gorging for 
seven days and starving for three — what else could be 
expected but sickness ? 

Since I have been the head of the sanitary depart- 
ment, every possible accusation instigated by sensation- 
alism, hostility to military rule, and self -laudation, has 
been hurled against me. 

Now what was the actual state of affairs under the 
different heads of medical control? 

1. Medical Supplies. — A howl about the scarcity 
of medicines and equipments was raised soon after I 
reached camp. I found about ten thousand men, with 
a daily increase of several thousand. I knew that the 
surgeon general had notified the governors of the sev- 
eral States that it would be impossible to have adequate 
medical equipment provided at such short notice, and 
had requested them to supply their regiments with their 
State outfit, and I had reason to expect that the ma- 
jority would come so supplied. What was my dismay, 
when I found an absolute insufficiency for more than a 
week or two, with regiments streaming in calling for 
ambulances to transport their sick, for medicines, for 
shelter, and I had nothing to give them! I had re- 
ceived my orders one day and was in camp the next, 
finding the above state of affairs. I did the only thing 
possible to lessen the probability of suffering by having 
an order issued calling in all supplies and centralizing 
the medical service, seizing upon the few regimental 
hospitals to provide tentage and equipments for all, and 



4 CAMP ALGER AND CAMP MEADE. 

taking the few regimental ambulances, in order to be 
able to convey the patients to the hospital and to isolate 
measles and mumps. 

No one suffered from this except those regimental 
surgeons, who naturally disliked giving up what they 
had provided for their special commands. It was the 
counterpart of shipwreck or a North Pole expedition 
demanding an equalization of rations. 

The result was, however, disastrous to me, for with 
newspaper reporters hungering for sensational accounts 
and disappointed doctors and their satellites, I was held 
up to the horror of mankind. 

Medical supplies can not be bought like beef or oats, 
and it took some time before rigid economy could be 
relaxed, while complaints kept pouring into the papers 
by surgeons whose expenditures I had to keep within 
the lowest reasonable limits. The extravagance in the 
use and waste of medicines was ahuost incredible. But 
no one ever died and few suffered from lack of medical 
supplies. 

2. Water Supply. — The next thing which not only 
perturbed the public mind, but even sanitarians, was the 
water supply. " Tliis was a matter which should be 
watched ! " It was ludicrous to imagine that a trained 
sanitary officer needed advice on the subject. 

My'first care tlie morning after I reached camp was 
to get an engineer and tlie proprietor of the camping 
grounds to locate tlie vaunt (h1 springs which^ had U'd 
to acceptance of the site by the (juartennaster's depart- 
ment, r found them to be surface drainage of insuffi- 
cient (juantity, and at once had an order issued placing 
them under guard and requiring all drinking water to 
be boiled. The next stc]) was the development of a suffi- 
cient and ])ure water supply, and to this end I accom- 
panied the engineer officer in the selection of suitable 
spols to drive wells. Their average de])th was a hun- 
dred and twenty feet and they passed through thick 
strata of rock. 

Still, 1 took samples of tlie water and had them 



CAMP ALGER AND CAMP MEADE. 5 

analyzed in the laboratory of the surgeon general's office, 
and wherever, as in a few instances, traces of organic 
matter were discovered, the wells were condemned. 

In order further to guard against possible contami- 
nation I obtained three hundred sets of Maignen and 
Berkefelt filters, and had minute orders given as to 
their use. 

On my arrival at Camp Meade I accompanied the 
commanding general in an inspection of the proposed 
camp sites, had all so-called springs, which were only 
the result of subsoil drainage, at once condemned, the 
other sources of water supply — namely, wells driven over 
two hundred feet and a limestone spring and water sup- 
ply of Middletown, Pennsylvania — analyzed, and found 
them pure. 

It would tire my readers to learn about the many 
reports I made concerning the disregard of sanitary 
recommendations, but I believe that I have established 
the fact that while Camp Alger had an insufficient sup- 
ply of water, every care was taken by me to do my share 
toward amplifying it. 

3. Sanitaky Police. — The sanitary policing of the 
camps was well regulated by orders issued on my recom- 
mendation, but these orders were persistently disobeyed. 
The privies as a rule were filthy. Sanitary inspections 
by regimental medical officers were either neglected, or 
their recommendations were disregarded by the colonels. 
I never learned of this disregard, as no reports were 
made to me by regimental, brigade, or division sur- 
geons, in spite of daily injunctions thereon. Every one 
seemed satisfied with the heauty of his camp, but ap- 
parently no one ever looked after the dejecta. When I 
made personal and special inspections, matters were 
remedied for a day or two, and they then relapsed into 
the old filth. I had not the time to institute disciplinary 
measures. 

On June 3d I had advised individual covering of 
faecal matter, principally for the purpose of prevent- 
ing infection by flies, and an order to that effect was 



6 CAMP ALGER AND CAMP MEADE. 

issued by the commanding general, but in the undis- 
ciplined condition of the troops this order could not be 
rigidl}^ enforced until the commencement of August. 
Since this time a sentry was placed at each privy to see 
that the order was complied with, and even with this 
precaution instances were observed where the order wa^ 
evaded. The neighboring woods and cornfields were 
used in preference by the men, with the natural result 
that most of the surface water became infected. Sen- 
tries posted to prevent the defiling of woods and corn- 
fields would not report their comrades, and it was 
consequently absolutely impossible to control the situ- 
ation. 

4. Food. — As to the food, I recommended as early 
as June 3d regulations regarding it. They were speed- 
ily ignored and, as a rule, ignorance of the order was 
pleaded to me as excuse. 

About the same time I recommended prohibition of 
the sale in camp of various articles of food which in 
my opinion were deleterious to the health of the troops. 
An order tliereon was issued by the general, but could 
not be enforced, owing to limitation of his authority 
to within the confines of the camp. 

5. Typhoid Fever. — As to the origin of typhoid 
fever, there wore a number of foci of infection, some of 
which could be reached, some could not. A few ex- 
amples will demonstrate this. 

Soon after tlie occupation of the camp, cases of 
typhoid fever occurred, coming from a nuiuber of regi- 
uKMits, and the patients were removed to tlic general 
hospital at Fort Myer. They were sporadic, one or two 
to a thousand men, and evidently imported, because 
the camp had not been in existence long enough to allow 
the necessary time for incubation. The cases became 
more frequent, although the water supply, officially ap- 
proved and provided, remained pure; but numbers of 
surface s})rings were all around the camps (they were 
more convenient than the pumps), and the men did 
not have to wait there for tlieir turn, so, in spite of 
prohibition, this use of surface water was general. 



CAMP ALGER AND CAMP MEADE. ^ 

A constant anxious search was made by me for pre- 
ventable infection. 

Thus it was found that a number of men of the 
Sixth Massachusetts Volunteer Infantry, who had been 
on provost duty at East Falls Church and had used 
the water there, were taken with typhoid. 

The water supply of the provost guard could not be 
controlled. 

The First New York Cavalry, who in their camp 
used either boiled, Hygeia, or Apollinaris water exclu- 
sively, had a number of cases. The only explanation 
which could be found was that these men were con- 
stantly on patrol duty and found the cool wells in 
neighboring farmhouses more acceptable than the warm 
H^ygeia water in their canteens. It is a well-known fact 
that many people in Washington, who spend the sum- 
mer on these farms, return with typhoid. 

Another source was found in a surface well driven 
by men of a Pennsylvania regiment in one company, 
which had a great many cases of typhoid, while the 
adjoining companies were free. Fortunately for these, 
the well owners guarded their well jealously. The regi- 
. mental surgeons knew of it, but it apparently did not 
^ctrike them as unsanitary. A company in another regi- 
ment was severely affected, while the adjoining ones 
were free. In that case the milk was suspected, but 
nothing was proved. 

The fact is that if the men had confined themselves 
to the water provided and to the food issued, if they 
had practised ordinary care, and if their officers had 
compelled them to submit to sanitary regulations, there 
would have been no typhoid fever. 

6. Sanitary Eecommendations. — No one man in 
my position could overcome the indifference to sanita- 
tion. A list of the sanitai:y recommendations made 
will show to what extent my care, for the health of, the 
troops was carried : 

1. Water-supply development. 

2. The location of wells according to need. 



8 CAMP ALGER AND CAMP MEADE. 

3. Eegiilations about drinking water and the care of 
its supply. 

4. The cooking of food. 

5. The care of privies. 

6. The disposal of refuse. 

7. The chemical examination of water. 

8. The prohibition of the sale of pies, ice cream, 
sandwiches, etc. 

9. Eecommendations for contracts with laundries, 
etc. 

10. The employment of contract surgeons. 

11. The flooring of tents. 

12. The overcrowding of tents and their close prox- 
imity. 

13. The establishment of urinals. 

14. The purification of drinking water. 

15. The removing of regiments from unhealthy loca- 
tions. 

16. The utilization of condemned tents for cover- 
ing privies. 

17. The replacing privy pits with earth closets, if 
the camp is to be continued. 

18. The employment of cooking instructors. 

19. Application for an analyst. 

20. Milk inspection. 

21. Detail of sanitary inspector. 

22. The use of filters. 

23. The change of camj)s. 

24. The individual covering of fjrcal matter. 

25. Detailed instructions for the use of filters. 

26. Analysis of water sup])ly. 

27. The policing of groumls around hydrants. 

28. Directions concerning disinfection. 

29. l\('i»oii Ml)out carelessness in the shi])ment of 
bread. 

;'.(). lirconunendation for military excursions. 

31. The sterilization of the men's blankets. 

32. Reports on water supply. 

33. Inspection of cleanliness of the men. 

34. liaising the tent floors. 



CAMP ALGER AND CAMP MEADE. 9 

7. Selection of Camps. — Finally, as to the selec- 
tion of Camp Alger as a camping ground, it must be 
remembered that the location was selected by the war 
department, and that neither myself nor the medical 
department in Washington was consulted. The only 
fault I could find was the lack of space and the scarcity 
of water. Both were corrected as rapidly as possible, 
and as soon as typhoid fever appeared other camp sites 
were examined, but found objectionable. Finally, it was 
decided to move the command to Thoroughfare Gap, 
and the Second Division went there; then the war de- 
partment decided to move the whole command to Camp 
Meade. 

An army corps is not like a regimental camp, and 
sites where all the desirable features can be found are 
scarce. Before Camp Meade was decided upon a large 
number of places were visited by officers from the war 
department, among whom was one of the most distin- 
guished hygienists of the medical corps. Colonel Smart. 

This paper — I should rather call it a sketch — has 
been written under numberless interruptions, which are 
inevitable in the sanitary and medical administration 
of thirty thousand men, and hence omissions and im- 
perfections may reasonably be pardoned. 

A. C. GiRARD, 

Lieutenant Colonel and Chief Surgeon, Second Army 
Corps. 



A REVISED EDITION OF 

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Major and Surgeon, Ninth Regiment, N. G. S. N. Y. ; late Attending 
Surgeon to Bellevue Hospital Dispensary, New York. 



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